NCLEX-PN

Chapter 6: Quiz & Answer Key 1.​ Which statement about total parenteral nutrition is true? A.​ Clients are at high risk for infection when they are getting TPN because they are immunocompromised B.​ Clients are at high risk for hyperglycemia when they are getting TPN because they are diabetic C.​ The client should perform the Valsalva maneuver when the nurse changes the TPN tubing D.​ The client should perform the Valsalva maneuver when the nurse changes the TPN dressing Correct Response: C Explanation : The client should perform the Valsalva maneuver when the nurse changes the TPN tubing to prevent embolism, which can occur when the tubing is opened to the air while it is being changed. A mask, not the Valsalva maneuver, is indicated for TPN dressing changes. Lastly, clients are at risk for infection secondary to TPN because these solutions are high in dextrose and because TPN is an invasive sterile procedure; and clients are at high risk for hyperglycemia when they are getting TPN because these solutions are high in dextrose and not because the client is already a diabetic client. (See Identifying TPN-Related Side Effects and Adverse Events ) 2.​ Select the opioid classification that is accurately coupled with an example of it AND a side effect or adverse reaction to it. Explanation : Dilaudid is an opioid agonist that can cause constipation. Other opioid agonists are codeine, OxyContin, Darvon, Dilaudid, Demerol, and Percocet. The side effects and adverse reactions to this classification of drugs include constipation, sedation, nausea, dizziness, pruritus, sedation, respiratory depression and arrest, hepatic damage, an anaphylactic reaction, circulatory collapse, and cardiac arrest. Opioid antagonists, also referred to as opioid receptor antagonists, such as naloxone and naltrexone, can have side effects such as hepatic damage, joint pain, insomnia, vomiting, anxiety, headaches, and nervousness. (See Opioid Analgesics ) 3.​ The best way to determine whether or not a medication is compatible with a particular intravenous fluid is to: A.​ Mix a small amount of the medication in a small amount of the intravenous fluid and then examine this mixture for color changes B.​ Refer to a compatibility chart C.​ Call the doctor and ask if the medication is compatible with the particular intravenous fluid A.​ Opioid Agonist: Dilaudid: Constipation B.​ Opioid Agonist: Naloxone: Constipation C.​ Opioid Antagonist: Dilaudid: Anaphylaxis D.​ Opioid Antagonist: Oxycontin: Anaphylaxis Correct Response : A

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